Comparison of diagnostic value between TIRADS and ultrasound patterns of ATA(2015)guidelines in the differentiation of benign and malignant thyroid nodule

Abstract

To compare the diagnostic value between the thyroid imaging reporting and data system(TIRADS)and ultrasound(US)patterns of 2015 American Thyroid Association(ATA)guidelines in the differentiation of benign and malignant thyroid nodules. 639 patients in Jiangsu province who were scheduled for ultrasound-guided fine-needle aspiration biopsy or thyroidectomy were recruited for the retrospective study. All of them were categorized based on TIRADS and ultrasound patterns of ATA(2015)guidelines. The receiver operating characteristic curve was established to assess and compare the diagnostic value of the two models. Results: (1)639 patients with 847 thyroid nodules were included in this study, 510 females and 129 males. The mean age was(46.77±12.98)years old. (2)818 nodules could be classified according to TIRADS. The malignancy rates of TIRADS 2, 3, 4A, 4B, 5 were 0, 15.9%, 49.1%, 78.8% , and 100%, respectively. (3)Ultrasound patterns of ATA could be assigned to 793 nodules. The malignancy rates of nodules with very low, low, intermediate, high suspicion for malignancy were 6.2%, 10.3%, 24.9% and 70.1%, respectively. (4)Ultrasound patterns of ATA had higher specificity(77.9%)compared to TIRADS. The sensitivity and area under curve of ultrasound patterns of ATA were lower than those of TIRADS, though, not significant. Ultrasound patterns of ATA(2015)guidelines may yield higher specificity in the differential diagnosis of benign and malignant thyroid nodules, while TIRADS classification may offer a relatively higher sensitivity and area under curve. (Chin J Endocrinol Metab, 2016, 32: 999-1002) Key words: Thyroid nodule; Thyroid imaging reporting and data system; Ultrasound patterns; 2015 American Thyroid Association guidelines